CAJ | 학술논문

目的探讨美托洛尔联合氟西汀预防偏头痛的疗效及可能机制。方法将112例偏头痛患者按照随机数字表法随机分为观察组和对照组，每组各56例。观察组给予琥珀酸美托洛尔联合氟西汀治疗；对照组给予琥珀酸美托洛尔治疗。比较两组受试者治疗前和治疗后头痛发作次数、头痛发作程度、头痛发作天数、颅内动脉血流情况。记录两组治疗前、治疗后2周、治疗后4周、治疗后6周血清5羟色胺（5- HT）水平。结果两组治疗后头痛发作次数、头痛发作程度、头痛发作时间均较治疗前有明显改善（ P <0.05），且观察组改善幅度优于对照组，差异有统计学意义（ P <0.01）；两组治疗后大脑中动脉（MCA）、前动脉（ACA）、后动脉（PCA）、椎动脉（VA）、基底动脉（VA）血流情况均较治疗前改善（ P <0.05），且观察组改善幅度优于对照组，差异有统计学意义（ P <0.01）；两组治疗前血清5- HT 水平比较差异无统计学意义（ P >0.05），观察组治疗后2周、4周、6周血清5- HT 水平较治疗前明显提高（ P <0.01），且提高幅度大于同期对照组，差异有统计学意义（ P <0.01）；观察组未出现严重不良反应。观察组偏头痛复发率低于对照组，差异有统计学意义（ P <0.05）。结论琥珀酸美托洛尔联合氟西汀预防性治疗偏头痛，比起单药应用，起效更快，疗效更明显，复发率更低；可有效改善患者偏头痛症状和颅内血流状况，疗效确切，其主要机制可能与提升患者体内5- HT 浓度有关。
목적탐토미탁락이연합불서정예방편두통적료효급가능궤제。방법장112례편두통환자안조수궤수자표법수궤분위관찰조화대조조，매조각56례。관찰조급여호박산미탁락이연합불서정치료；대조조급여호박산미탁락이치료。비교량조수시자치료전화치료후두통발작차수、두통발작정도、두통발작천수、로내동맥혈류정황。기록량조치료전、치료후2주、치료후4주、치료후6주혈청5간색알（5- HT）수평。결과량조치료후두통발작차수、두통발작정도、두통발작시간균교치료전유명현개선（ P <0.05），차관찰조개선폭도우우대조조，차이유통계학의의（ P <0.01）；량조치료후대뇌중동맥（MCA）、전동맥（ACA）、후동맥（PCA）、추동맥（VA）、기저동맥（VA）혈류정황균교치료전개선（ P <0.05），차관찰조개선폭도우우대조조，차이유통계학의의（ P <0.01）；량조치료전혈청5- HT 수평비교차이무통계학의의（ P >0.05），관찰조치료후2주、4주、6주혈청5- HT 수평교치료전명현제고（ P <0.01），차제고폭도대우동기대조조，차이유통계학의의（ P <0.01）；관찰조미출현엄중불량반응。관찰조편두통복발솔저우대조조，차이유통계학의의（ P <0.05）。결론호박산미탁락이연합불서정예방성치료편두통，비기단약응용，기효경쾌，료효경명현，복발솔경저；가유효개선환자편두통증상화로내혈류상황，료효학절，기주요궤제가능여제승환자체내5- HT 농도유관。
Objective To study effect of metoprolol combined with fluoxetine treating migraine and its possible mechanism. Methods During the period of 2011 January to 2014 December,112 cases of migraine patients were selected as the research object. 112 patients were ran-domly divided into observation group and control group,56 cases in each group. The observation group included 56 patients,who were given Meto-prolol Tablets combined fluoxetine treatment. The patients of control group of 56 patients were treated with Metoprolol. The statistics of the two subjects,episodes of headache degree,headache days,intracranial arterial blood flow headache before and after the treatment were made. The re-cords of serum level of 5 - HT of the two groups before treatment,2 weeks after the treatment,4 weeks after the treatment,6 weeks after the treat-ment were made. Results Headache attack frequency,headache degree,headache time improved in two groups after treatment than before treat-ment( P < 0. 05). The observation group improved better than the control group,and there were significant differences( P < 0. 01). The two group after treatment,MCA,ACA,PCA,VA,VA were improved compared with before treatment( P < 0. 05),and the observation group im-proved better than the control group,and there were significant differences( P < 0. 01). The serum 5 - HT level was not statistically different be-tween the two groups before treatment( P > 0. 05),the observation group after treatment for 2 weeks,4 weeks,6 weeks,the levels of serum 5 -HT than before treatment significantly increased( P < 0. 01),which was greater than the same period in the control group,and there were signifi-cant differences( P < 0. 01). There was no serious adverse reaction in the observation group. The migraine recurrence rate of the observation group′s was lower than the control group,and there were significant differences( P < 0. 05). Conclusion Metoprolol combined with fluoxetine treating migraine,compared with the single drug application,has faster onset,and its curative effect is more obvious,and the recurrence rate is lower. It can effectively improve the patients′ migraine symptoms and intracranial blood flow condition,and its curative effect is accurate,and its main mechanism is to enhance 5 - HT concentration in patients.